In 2012, a study conducted by Toupet, et. al., aimed at identifying the most effective repositioning maneuvers for treating benign positional paroxysmal vertigo (BPPV), researchers compared the efficiency of the Epley (Ep) and Sémont-Toupet (ST) maneuvers. Additionally, the study evaluated the impact of postmaneuver restrictions on vertigo and dizziness, using an analog visual scale (VAS) for assessment.

The study included 226 adult patients diagnosed with posterior canal BPPV. These patients were randomly assigned to one of two maneuver sequences: 2 ST maneuvers followed by 1 Ep, or 2 Ep maneuvers followed by 1 ST, with each sequence group comprising 113 patients. Further randomization divided these groups into subgroups with or without postmaneuver restrictions. Vertigo and dizziness were tracked and measured daily using the VAS from day 0 to day 5.

The findings indicated no significant difference in vertigo scores between the Epley and Sémont-Toupet groups. However, dizziness scores were initially higher in the Epley group during the first three days, but by days 4 and 5, these scores leveled out and matched those of the Sémont-Toupet group. Notably, the Sémont-Toupet maneuver induced liberatory signs more frequently than the Epley maneuver (58% vs. 42%, P < 0.01, Fisher’s test). Despite this, VAS scores showed a similar reduction in patients regardless of the presence of liberatory signs. Importantly, the study found that postmaneuver restrictions did not affect VAS scores.

While the Sémont-Toupet maneuver demonstrated a higher occurrence of liberatory signs compared to the Epley maneuver, these signs did not influence the VAS scores for vertigo and dizziness. Furthermore, imposing postmaneuver restrictions showed no impact on the patients’ VAS scores, suggesting that these restrictions may be unnecessary in managing BPPV symptoms.

Reference: Toupet, M., Ferrary, E., & Grayeli, A. B. (2012). Effect of repositioning maneuver type and postmaneuver restrictions on vertigo and dizziness in benign positional paroxysmal vertigo. The Scientific World Journal, 2012.